Associate Professor Bebe Loff, ethicist and director of the Michael Kirby Centre For Public Health and Human Rights at Melbourne’s Monash University, said an external inquiry, perhaps by an Ombudsman, was required.

Prof Loff made the call after The Sunday Times revealed last week that WA’s PBM program – aimed at cutting blood transfusions to patients in public hospitals – was spearheaded by two Jehovah’s Witnesses.

Prof Loff, who has been on the World Health Organisation’s ethical review committee and the Australian Health Ethics Committee, said it was very important to maintain public confidence in the sensitive area of blood transfusion.

“The raising of doubt about the safety of blood that might be used for transfusion can have an impact on people’s willingness to accept blood products and their willingness to donate,” she said.

Prof Loff said the intent of the program – to make best use of blood, an extremely limited resource – made intuitive sense.

But the program’s implementation in WA and the selection of the two men chosen to do it – Shannon Farmer and Axel Hofmann, whose religion is opposed to blood transfusions – raised questions.

Professor Loff said the intent of the PBM made ‘intuitive sense’.Source: Supplied

Prof Loff said the Government did not appear to have regarded the fact they were Jehovah’s Witnesses as a matter of importance, rather that it was their capacity to do the job that mattered.

Ordinarily a person’s religious background might not be relevant, she said, but there was a very widely known position on the part of Jehovah’s Witnesses around the use of blood and blood transfusions.

“I would have thought it was entirely proper and, in fact, required to inquire into this further,” Prof Loff said.

Questions have been raised about Axel Hofmann’s suitability for the PBM program.Source: Supplied

Well-known WA GP Dr Joe Kosterich echoed the call for an external review and emphasised it should not be conducted by anyone connected to the Health Department.

Dr Kosterich said reducing the need for blood was a good idea because transfusions could cause a response in the body that made recovery a bit slower.

Also, if elective surgery patients were prepared properly beforehand and blood loss was avoided during operations, it would be better for them.

But he questioned the contract with Mr Farmer and Mr Hofmann.

“People who are Jehovah’s Witnesses are probably the worst people to implement this sort of program because there is a perception that they are doing it for religious, not medical, reasons,” he said. “I think it is an issue of perception.

“If you wanted to talk about the side effects of the contraceptive pill, probably if you wheeled out a Catholic priest, they might say, ‘Well, you’re against the Pill on religious grounds, not medical grounds, you’re just trying to make it look like you’re using medical reasons’.”

Prof Loff said some of the literature by the two men seemed to convey the view that transfusion was dangerous.

“Whilst that may sometimes be true and it may sometimes be the case that blood transfusions are given where alternative approaches could do the job, I find it very hard to accept a position that conveys an increasingly negative view of transfusion,” she said.

A spokesman for the Australian Red Cross Blood Service said it supported PBM and its intention to improve transfusion practices and outcomes.

Shannon Farmer was hired as a consultant for the PBM program.Source: Supplied

BIG EURO CONTRACT COSTS 10% of WA'S

THE two Jehovah’s Witnesses who got almost $4 million of taxpayers’ money to introduce a Patient Blood Management program in WA are involved in a much bigger contract to do the same in the European Union that is costing about one tenth of the price.

The EU contract, worth just 300,000 euros ($443,000), is for the establishment of pilot programs in major teaching hospitals in five countries – spread across the length and breadth of Europe – and the development of a “how to’’ PBM manual and training course for all 28 member states.

Axel Hofmann and Shannon Farmer have been hired as consultants by the successful tenderer, the Austrian Institute of Technology, a partly government-owned R&D organisation in Vienna.

Mr Hofmann, a health economist who lives in Austria, will be on the core project team. Perth-based Mr Farmer, who co-founded a “bloodless’’ surgery program at Fremantle’s Kaleeya private hospital in 1990, will be a member of a seven-member international “expert panel’’ who will act as advisers to the project.

As The Sunday Times revealed last week, Mr Hofmann, Mr Farmer and an American associate were paid $3,901,703 by the WA Health Department to implement a “system-wide’’ PBM program in the state’s public hospitals.

The net result of the five-year contract was that PBM strategies have been implemented in just four hospitals – Fremantle, Royal Perth, Sir Charles Gairdner and King Edward Memorial. The roll-out began at the 450-bed Fremantle Hospital in 2009 with a three-year pilot scheme.

Under the 30-month EU contract, AIT has to develop pilot programs in five teaching hospitals, each with a minimum of 750 beds, that have “no or moderate’’ implementation of PBM. Initially, the project team must do a “baseline evaluation’’ of patient outcomes and transfusion risk and blood use at each hospital.

The team also has to do an overall evaluation of the pilots after a year, analysing the strengths and weaknesses of the program.

A key criterion of the tender was that the project head was medically qualified, with experience in blood transfusion. Mr Hofmann and Mr Farmer are not medical doctors.

The AIT team leader has been named as Professor Dr Hans Gombotz, who retired in March as head of the Department of Anaesthesiology and Intensive Care at Linz General Hospital in Austria.

The Health Department failed to respond when asked about the cost differential.

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